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内翻膝骨关节炎的开放性楔形高位胫骨截骨术:一项5年前瞻性队列研究。

Open-wedge high tibial osteotomy in varus knee osteoarthritis: a 5-year prospective cohort study.

作者信息

Pongsoipetch Buntoeng, Tantikul Chaichana

机构信息

Orthopaedic Division, Charoenkrung-Pracharak Hospital, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2009 Dec;92 Suppl 6:S109-14.

Abstract

BACKGROUND

High tibial osteotomy (HTO) is an accepted procedure to correct the varus deformity to restore the mechanical axis, reduce pain and delay the need for arthroplasty, especially in young and active patients. Nowadays, the opening wedge HTO is preferable than the close one.

OBJECTIVE

To evaluate the clinical results and complications of medial compartment gonarthrosis treated with opening wedge HTO.

MATERIAL AND METHOD

The prospective cohort study of 45 knees in 40 consecutive patients (32 women, 8 men, 46-81 years) with medial compartment osteoarthritis of the knee underwent medial open-wedge HTO and TomoFix between February 2004 and February 2009 (average follow-up of 46.1 +/- 11.5 months).

RESULTS

During the follow-up period, patients experienced significantly greater pain relief from baseline pain-intensity scores (all p < 0.001). The mean femorotibial angle (FTA) at the preoperative, 1-year and more than 2-year follow-up were 171.27 +/- 9.41 degrees of varus, 182.91 +/- 4.93 and 182.45 +/- 5.74 degrees of valgus, in orderly.

CONCLUSION

Medial opening wedge HTO with TomoFix provided intraoperative desirable correction and sufficient stabilization. Early mobilization, rehabilitation and maintenance of correction alignment until bony union occurred without instrument failure.

摘要

背景

高位胫骨截骨术(HTO)是一种公认的用于矫正内翻畸形以恢复机械轴、减轻疼痛并延缓关节置换需求的手术,尤其适用于年轻且活跃的患者。如今,开放楔形HTO比闭合楔形更受青睐。

目的

评估采用开放楔形HTO治疗内侧间室膝骨关节炎的临床效果及并发症。

材料与方法

对2004年2月至2009年2月期间连续40例患者(32例女性,8例男性,年龄46 - 81岁)的45个膝关节内侧间室骨关节炎行内侧开放楔形HTO及TomoFix固定进行前瞻性队列研究(平均随访46.1±11.5个月)。

结果

在随访期间,患者疼痛强度评分较基线有显著缓解(所有p<0.001)。术前、1年及2年以上随访时的平均股胫角(FTA)依次为内翻171.27±9.41度、外翻182.91±4.93度及182.45±5.74度。

结论

采用TomoFix的内侧开放楔形HTO在术中提供了理想的矫正及充分的稳定。早期活动、康复并维持矫正对线直至骨愈合,且未出现器械故障。

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